Pill is designed to stop menstrual periods long-term

They call it Code Red, The Curse, Aunt Flo and 1,000 other nicknames. And they love complaining about all that comes with it: the bloating, the cramps, the mood swings.

MAURA LERNER and JOSEPHINE MARCOTTY

They call it Code Red, The Curse, Aunt Flo and 1,000 other nicknames. And they love complaining about all that comes with it: the bloating, the cramps, the mood swings.

But are women really ready for a pill that would do away with their monthly periods?

Last week, the Food and Drug Administration approved a birth control pill called Lybrel, which is designed to stop menstrual bleeding. It's bound for pharmacies in July.

To some, it's the ultimate in meddling with Mother Nature, a reckless attempt to rid the female body of one of its most primal functions for the sake of convenience.

Yet others call it a welcome relief from painful periods and other serious conditions, and no more unnatural than the birth control pill itself.

In some ways, the polar reactions reflect the love-hate relationship that women have long had with the menstrual cycle. It's inconvenient, messy and sometimes painful — and a powerful symbol of women's coming of age and sexuality.

"There are women who love the idea of not having a period, and as long as we say it's safe, they're fine with it," said Dr. Marilyn Joseph, an obstetrician-gynecologist and medical director of the University of Minnesota's Boynton Health Service. And "there are those who say, 'It just doesn't seem right.' "

Wyeth, which makes Lybrel, had surveyed women and found that nearly one-third said they would never want another period again.

But Dr. Susan Rako, a Boston psychiatrist and author of "No More Periods? The Blessings of the Curse," called it "the largest uncontrolled experiment in medical history." The fact is that there are real risks to menstrual suppression," she said. "What we're talking about is the risk of dosing teenagers and young women for years with potent hormones, day after day, in order to do away with periods," she said. "What are we going to learn 40 years from now?"

In the last few years, a new generation of birth control pills (called Seasonale and Seasonique) has allowed women to reduce the frequency of periods to four times a year. Lybrel is the first that would do away with them completely; however, many women involved in testing the drug continued to experience spotting or breakthrough bleeding.

Birth control pills have always had the hormonal power to stop periods. But in the 1960s, when "the Pill" first came out, it was designed to mimic the menstrual cycle to make it more palatable to users. Women would take three weeks of hormones and then a week of dummy pills, which allowed for a monthly flow of blood.

It wasn't the same as nature, but it was a plausible substitute. "Nature's cycle is interrupted as soon as you start on birth control pills," said Joseph, adding that nature reasserts itself as soon as the pills are stopped.

But it's been an open secret for years that birth control pills can stop bleeding and the problems that sometimes occur with menstruation. Doctors often recommend skipping the dummy pills and continue taking the hormone pills.

Sometimes, the reasons are more fleeting — such as postponing a period for a camping trip or wedding.

"Women figured this out decades ago," said Dr. June LaValleur, a gynecologist and women's health specialist at the University of Minnesota. "They've been doing it for convenience for a long time."

In fact, a 2003 Gallup poll found that 99 percent of women obstetrician-gynecologists believed it's safe to use birth control pills to delay or eliminate periods. Half said they had done it themselves.

Although birth control pills have been around for decades, the risks that come with suppressing periods for years at a time are unknown.

Dr. Amy Marren, director of clinical affairs at Wyeth, said that Lybrel contains the same hormones as other birth control pills, but acknowledges that it was only tested for a year on 2,500 women.

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